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Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

149 points by Alex3917 8y ago

akuji1993 8y ago
When I opened this, I thought they meant 72000 on the whole world. Nope, it's just the US. That's an unbelievably high number to me.
- jgtrosh 8y ago
  It's staggering! I just compared with traffic accident fatalities in 2017 and it's 40,200 (according to [1]). It hadn't occurred to me that drugs were a bigger killer than traffic accidents. Now maybe there's a big overlap over the two figures? Edit: just realized the drug death count is only for ODs, so the overlap wouldn't be significant. [1]: https://www.nytimes.com/2017/02/15/business/highway-traffic-safety.html https://www.nytimes.com/2017/02/15/business/highway-traffic-...
- DanBC 8y ago
  Look at the rate of opioid use in the US compared to the rest of the world. The US consumes about 99% of the world supply of hydrocodone. https://www.washingtonpost.com/news/wonk/wp/2017/03/15/americans-use-far-more-opioids-than-anyone-else-in-the-world/?utm_term=.b5705cca9112 https://www.washingtonpost.com/news/wonk/wp/2017/03/15/ameri... These figures are old (2015), but eye-opening. http://www.painpolicy.wisc.edu/who-regional-office-americas-amro http://www.painpolicy.wisc.edu/who-regional-office-americas-... http://www.painpolicy.wisc.edu/sites/default/files/sites/www.painpolicy.wisc.edu/files/amro_oxycodone.pdf http://www.painpolicy.wisc.edu/sites/default/files/sites/www... http://www.painpolicy.wisc.edu/sites/default/files/sites/www.painpolicy.wisc.edu/files/amro_morphine.pdf http://www.painpolicy.wisc.edu/sites/default/files/sites/www... Here's EURO http://www.painpolicy.wisc.edu/sites/default/files/sites/www.painpolicy.wisc.edu/files/euro_oxycodone.pdf http://www.painpolicy.wisc.edu/sites/default/files/sites/www... http://www.painpolicy.wisc.edu/sites/default/files/sites/www.painpolicy.wisc.edu/files/euro_morphine.pdf http://www.painpolicy.wisc.edu/sites/default/files/sites/www... You can use that site to compare regions. http://www.painpolicy.wisc.edu/explore-data http://www.painpolicy.wisc.edu/explore-data
- glbrew 8y ago
  It really is huge. It is so high experts describe it as a "demographic change," It is literally changing the demographics and population distribution of the US.
bumholio 8y ago
I cannot but wonder if North Americans feel responsible in the least for what their voracious appetite for drugs is doing south of the US border. Mexico has become almost ungovernable, the drug trade being one of the main factors driving the decline.
- dasil003 8y ago
  The appetite for drugs or the criminalization that creates the black market? Heavy drug users have more immediate concerns than second and third order effects of their lifestyle choices. The politicians and lobbyists responsible for maintaining the status quo on the other hand, should probably pull their heads out of their asses.
  - bumholio 8y ago
    I am sure a widescale decriminalization of hard drugs south of the US border will be applauded in Washington. It would solve a large part of the drug crime problems in these countries, while raining down industrial quantities of pharmaceutical grade heroin on the US streets.
    - JamesBarney 8y ago
      I had a ex-friend(went to middle school with him) die recently from a drug overdose, and when I was talking with his parents on the way to the burial site his dad said that he could take him to any town in the U.S. and he could find heroin, get back to the hotel, and get high in under an hour. I don't think supply is limiting the amount of drugs that abusers are doing.
    - dredds 8y ago
      It was tried, was a success, and wasn't applauded. https://news.ycombinator.com/item?id=17608261 https://news.ycombinator.com/item?id=17608261 It's been effective in the countries that have tried it since. Overdose is the failure of dose management. Harm reduction is less profitable than addiction. Wars create jobs and huge profits. Collateral damage is the human cost. Success wasn't the goal.
announcerman 8y ago
The amount of responsibility laundering that's happening is staggering. Is it the fault of the doctors for prescribing strong painkillers or the responsibility of lobbyists for keeping the status quo as it is. Or is it the responsibility of patients to not seek strong opiates for the smallest aches? On whom falls the blame for this?
- thedailymail 8y ago
  You forgot to mention the drug manufacturers like Purdue, which aggressively promoted their opioids (e.g., Oxycontin) as presenting only a very low risk of addiction and abuse. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/
- ryan-allen 8y ago
  A few documentaries I've watched suggest that the dosages as recommended by the drug companies are designed to induce withdrawal symptoms before the next dose is due during treatment, I'd wager that's a good way to induce dependence during the course of treatment. The hypocrisy of the law when it comes to this is insane, but given how large the profits are and the power that money commands with lobbying, I'm not really surprised.
  - SquareWheel 8y ago
    Honestly, that sounds very conspiratorial and baseless. It assumes doctors are idiots and drug producers are comic book villains. Reality is more nuanced.
    - oldgradstudent 8y ago
      Sadly, assuming by default (until proven otherwise) that doctors are idiots, and drug producers are comic book villans may be the smart thing to do. http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/ > Purdue has known about the problem for decades. Even before OxyContin went on the market, clinical trials showed many patients weren’t getting 12 hours of relief. Since the drug’s debut in 1996, the company has been confronted with additional evidence, including complaints from doctors, reports from its own sales reps and independent research. Or https://study329.org https://study329.org
crazy_monkey 8y ago
Thanks big pharma!
deleted 8y ago
[deleted]
simula67 8y ago
> Analysts pointed to two major reasons for the increase: A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year. So, the increase in deaths is likely because of drugs becoming more deadly. How are drugs becoming more deadly ? It seems like this is how: > Strong synthetic opioids like fentanyl and its analogues have become mixed into black-market supplies of heroin, cocaine, methamphetamine and the class of anti-anxiety medicines known as benzodiazepines. Unlike heroin, which is derived from poppy plants, fentanyl can be manufactured in a laboratory, and it is often easier to transport because it is more concentrated. > In some places, the type of synthetic drugs mixed into heroin changes often, increasing the risk for users So, preventing this blending of drugs could potentially improve the situation > The number of opioid users has been going up “in most places, but not at this exponential rate,” said Brandon Marshall, an associate professor of epidemiology at the Brown University School of Public Health. “The dominant factor is the changing drug supply.” Not sure how this happens is explained in the article, but that could potentially be another attack vector
- merinowool 8y ago
  If people had easy access to clean drugs, deaths could be avoided. Opiates are fairly safe if dose is correct and are not contaminated. Then people could get psychological help to remove the need to take them.
toomanybeersies 8y ago
As a comparison, the road toll in the USA is 33,000 per year. Firearms kill about the same number (including 20,000 suicides). 3,000 people were killed in the 9/11 attacks. 72,000 overdose deaths is just a staggeringly large number.
- emiliobumachar 8y ago
  Thanks, you've put the number in perspective. More deaths than cars and guns combined. Staggering indeed.
  - greatpatton 8y ago
    And that's the main reason life expectancy in the US is declining: https://www.sciencedaily.com/releases/2018/08/180815190526.htm https://www.sciencedaily.com/releases/2018/08/180815190526.h...
- deleted 8y ago
  [deleted]
- village-idiot 8y ago
  Overdosed actually overtook vehicle deaths before most public health officials realized that something horribly wrong was going on. That we still haven’t done much about it is deeply distressing, tbh. I feel it’s a sign that we’re losing the ability to act towards unified goals, even politically safe ones like “no more drug overdoses please”.
  - CydeWeys 8y ago
    Stopping drug overdoses is far from a politically safe goal though, because you need to stop the war on drugs and take a less draconian approach, which goes directly against the hard-line stance of the Republican party.
    - village-idiot 8y ago
      Eh, I think you might be injecting too much partisanship into my original point. Stopping drug overdoses is popular across the board, but some of the tactics to accomplish that are not. We aren’t even at step zero, pretending to give a shit at the national level. You also need to factor in the victims, or rather their demographics. To be brutally honest, past victims of heroin were often minorities who lived in inner cities. Blacks in urban ghettos and gays cut off from all social support in particular, plus homeless people of all stripes. It was easy for people to pretend that those victims were simply immoral fools who got their just desserts. Now the victims are increasingly the children of white, suburban, middle class families. This has brought the crisis much closer to the heart of American political power, and made it much easier for the average voter to know someone who is addicted to or died from opiates. In theory this should reduce the drive for draconian drug war tactics, since the victims are neighbors and not brown boogeymen over in the big bad city. This doesn’t seem to be happening at the political level, which is weird and disconcerting.
PiggySpeed 8y ago
This is absolutely terrible. I worked in an inner-city setting servicing the addictions and psychiatry population as the fentanyl crisis started evolving several years ago. I would see the usual patient every day with no signs of instability, until they suddenly disappeared for a few days and were later found to have overdosed. Perfectly ordinary, pleasant people. We try to prevent these events by sending teams around to check up on them daily. However, resources are limited and we couldn't closely monitor everyone. One of our patients had come across multiple close calls, but no amount of persuasion would entice him to use his drugs in one of those public injection sites, or to invest more heavily in drug therapy. I have some hope for injectable hydromorphone programs being offered in pharmacies. Patients would come into a private room with a dose already measured out by the pharmacist. Pharmacies can already offer an unparalleled degree of monitoring since they see their patients on a daily basis.
- merinowool 8y ago
  Too many people profit from those deaths to have this happened.
Nursie 8y ago
The war on drugs is a staggering failure. Drugs have infiltrated every level of society, from business leaders and politicians to white and blue collar workers, to the bums on the street. Drugs are causing tens of thousands of deaths a year in the US alone. I dread to think the global total. The casualties of this war are mounting up rapidly. This is before we even count the criminals and enforcers killed in open combat. Whole countries are on the verge of civil war or just plain collapse. Yet in most countries talk of reform is either treated disparagingly or suspiciously, as if all the speaker is interested in is a quick toot, or as if they are a collaborator or traitor. It's sick, it's weird, and it's deeply disastrous. Meanwhile in Portugal, where possession is decriminalised, things seem to get better all the time.
- ssijak 8y ago
  It is very hypocritical for some politician to tell me what I can and what I can`t put into my body. Recently in UK they enacted a law that criminalize any substance that changes how you feel, but with the following remark "The ban is so wide-ranging that a long list of substances such as alcohol, tobacco, caffeine, food and medical products will have to be given special exemptions." When you thought that you reached the limits of hypocrisy...
  - Nursie 8y ago
    Whilst I agree with you - this doesn't even seem like the important piece any more. The ludicrous policies are killing hundreds of thousands a year and making life hell for so many more. It shouldn't even be a question about the morality of taking drugs or the hypocrisy of trying to stop it while carving out extensions any more - it's way more important than that.
  - claydavisss 8y ago
    If you expect society to share the burden of funding your healthcare, you should expect to share oversight of your habits.
    - maxerickson 8y ago
throwaway77384 8y ago
Why decriminalise drug use, when you can reap billions in profits from the deaths of thousands instead? I'm not sure that's what people meant when they requested drugs be regulated and taxes used for the greater good...
some_account 8y ago
This is by design. Look at any comedy movie these days, and the young adults are doing drugs. It has become as natural as eating junk food. People view being drugged and dumb to be fine these days because that's the Hollywood propaganda and it's everywhere in western society.
- pjc50 8y ago
  .. are you sure? This is the same Hollywood that's been editing cigarettes out of movies? Could you cite an example scene?
  - yznovyak 8y ago
    ??? Are you for real? Just google "stoner movies". Off top of my head: The Pineapple Express, This is the End, Harold and Kumar go to the White Castle, Jay and Silent Bob strike back.
    - pjc50 8y ago
      Weed (now legal in several states and not related to overdose deaths) is a different prospect to opiates, though.
      - yznovyak 8y ago
        You can argue that weed is legal because of sustained Hollywood propaganda.
    - cogidub 8y ago
      I'm not sure stoner movies are equivocal to increasing broader drug use generally. Studies show that legal marijuana is associated with decreasing opiate prescriptions https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2676997 https://jamanetwork.com/journals/jamainternalmedicine/articl...
- Entalpi 8y ago
  Blaiming peoples behaviour on entertainment products is a very weak claim. Might as well blaim the gun violence on video games.
justsomedude43 8y ago
Natural selection.
- phito 8y ago
  Being addicted is not a weakness. Some drugs are stronger that any willpower. When your doctor prescribes it to you like candy, it's really not the person's fault if he becomes addicted to it. Please don't be ignorant and blame the victims.
  - justsomedude43 8y ago
    Being addicted is not, but becoming addicted is. Nobody is physically forced into addiction.
    - PiggySpeed 8y ago
      Counterexample: patient has severe pain, is treated in the hospital with opiates, becomes addicted to opiates.
    - Uberphallus 8y ago
      Actually there are genetic factors that predispose you to addictive behaviors and substances. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715956/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715956/
    - Kurtz79 8y ago
      As OP says, many became addicted because of normal painkillers prescriptions from their doctors, not because they wanted to act cool in front of their friends. You don't generaly second-guess your doctor's prescription.
- PiggySpeed 8y ago
  Wrong attitude. I think you would benefit from meeting more people from different socioeconomic backgrounds.
yters 8y ago
Interestingly, this all is happening through legal routes. What would happen if hard drugs are fully legalized? Another weird thing, there are already loads of deaths through overdoses in the inner city, but only now it is an epidemic? What changed?
- Apfel 8y ago
  I see your point, but most overdoses are likely due to imperfect dosage information (excluding suicide, obviously). I think there may be some argument for legalisation but with medically-supervised consumption in pharmacies or specialised clinics. Overdoses could (excepting human error) be removed entirely with improved dosage calculations from experienced healthcare staff.
- 3x 8y ago
  Overdoses would decrease. Nearly all recreational drugs should be legalized with regulation to promote safe drug use. These substances should be sold in single individually-packaged doses, with clear and explicit labeling. Taxation can be used to selectively promote the use of safer alternatives to the hardest drugs, for example making marijuana, opium, and mushrooms cheap compared to drugs with a high risk of overdose or long term health implications. The most dangerous drugs like fentanyl can remain prohibited and there will be no market left for them. And, most important of all, the violent black market around drugs would be massively diminished, and there would no longer be situations where addicts are scared to call an ambulance because they will end up in jail. Inconsistent drug purity by itself is a huge factor in opioid overdoses, and it is one of many harmful side effects of criminalization that will effectively disappear under a well-regulated legal market.
  - yters 8y ago
    The prior question is: what is causing overdoses? My understanding is the opioids are already regulated, controlled, and dosed appropriately, since most are acquired through medical prescription. Why so many overdoses, then? My hypothesis is the drugs are addictive, and it takes more to get the same high each time, which eventually leads to accidental overdose. Additionally, drug use can lead to feeling trapped and hopeless, and that might cause people to either carelessly or intentionally overdose.
austincheney 8y ago
I have always wondered how pain killers could be so addictive. Stimulants are physically addictive. They modify signals in your physiology to increase signal performance, in some way, and the body reacts to the temporary performance boost. There is a craving for the stimulant the body has becoming reliant upon and a withdrawal in the absence of that chemical. This manner of physical addiction isn't a choice and everybody is roughly equally at risk. Even laxatives are equally physically addictive in this manner even though there is absolutely no modification to behavior from laxative consumption. Pain killers, and other depressants, on the other hand, don't work this way. With a very narrow exception to extreme alcohol consumption depressants are not immediately physically addictive. They require a modification to behavior to be addictive. In this way marijuana, which has no known physically addictive properties, has shown to be addictive to a small segment of users. I have always wondered how depressant addiction occurs. Unlike with stimulants we are not all created equal. Some people are more prone to addiction from depressants than others. Some few people do not find depressants at all addicting and even detest their use. It makes me wonder what is the primary behavioral switch that enables this manner of addiction.
- Nursie 8y ago
  It's rather simplistic to view opiates as mere depressants. They also create euphoria. I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe, or that you can generalise across multiple, vastly different families of drugs like this...
  - austincheney 8y ago
    > It's rather simplistic to view opiates as mere depressants. They also create euphoria. Perhaps for some people that is true. I was given a strong does of opiates for pain at a hospital before and I did not find the experience either pleasant or euphoric. That level of numbness and loss of motor control was actually a dreadful and even fearful experience. It really made me question which was worse between that experience and the pain it relieved. > I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe Are there exceptions?
nkkollaw 8y ago
Pharmaceutical companies keep lobbying for being able to give people opioids lightly, and keep giving doctors bonuses, to get people hooked until it's too late to go back. It's really true that the world works backwards. That's hundred of times the deaths from terrorism, yet the US government is completely ignoring this trend. If heroin is criminalized, so should be these practices, yet everyone is making money off of this: corporations, doctors, shareholders, politicians.
sergefaguet 8y ago
and while this opioid shit is legal, psilocybin and LSD are not. why should i have any respect for the legal system again? as opposed to seeing it as a dumb bully with no moral authority?
qudat 8y ago
How many of these overdoses were because of suicide?
dalbasal 8y ago
Looks like a sharp rise in heroine, cocaine & speed deaths too, even if shallower than opioids. Curious what a longer term chart would look like. This only charts 3 years. Is it normal, having such big annual changes?
perl4ever 8y ago
It seems like the term "overdoses" is obscuring the problem which is more "toxic (lethal) stuff is increasingly being mixed into illicit drugs of all kinds".
- perl4ever 8y ago
  This point happens to be prominent in my mind, because I happened to see some material the other day intended for drug education in schools that talked about the dangers of marijuana, especially the "synthetic kind". Even though I am not particularly pro-pot, and I do see the real problem here, it made me very uncomfortable. The less misleading thing to say, in my opinion, would be simply "street drugs can have poison or unknown drugs in them, and can kill you". Framing the problem is not just a matter of arbitrary mental games. Empirically, there is a real phenomenon, that people are dying more than they used to, and blaming doctors is the consequence of not reasoning properly about it. Unregulated drugs have always had the potential to have bad things in them, but if that is an increasing problem, we need to find out the root cause. Assuming doctors or drug companies have become greedier, assuming victims have become more susceptible to addiction, strike me as refusing to acknowledge what an explanation would even look like.
- pitaj 8y ago
  There's a simple solution: legalize all drugs. All of them. Let people get what they want. Then, if the government must do something, pump all that money they were spending on the drug war into treatment centers.
  - perl4ever 8y ago
    I can't see how eliminating regulation of drugs is going to solve the problem of people getting substances that are harmful or ineffective. There is no simple solution, only the obvious complicated one of regulating correctly.
naccato 8y ago
The sad truth is, the U.S. is a country that emphasizes punishment over rehabilitation, and we've brought this upon ourselves by isolating people and banning access to substances that they've become dependent on. The solution here is not complex: give addicts safe access to the substances they're addicted to and resources for improving their situation. It's disheartening, to say the least, that one of the main strategies for dealing with this is apparently "reducing medical prescriptions of opioids". People are in pain -- they need to be helped. I highly recommend the book Chasing the Scream, for anyone who's looking for a primer on the War on Drugs. It traces the hysteria around drug use back to the 1930s, when race panic was used to push forward prohibition in the face of mounting evidence against that strategy.
- shady-lady 8y ago
  On "Chasing the Scream", I would just include the disclaimer that Seth Mnookin(a professor of science writing at M.I.T) in his NYT review stated: > Unfortunately, his misunderstanding of some of the basic principles of scientific research — that anecdotes are not data; that a conclusion is not a fact — transforms what had been an affecting jeremiad into a partisan polemic. https://www.nytimes.com/2015/02/15/books/review/chasing-the-scream-by-johann-hari.html https://www.nytimes.com/2015/02/15/books/review/chasing-the-...
- taurath 8y ago
  The traditional rural tough on crime voters are now dealing with the dissonance when its their communities and families that are being ripped apart. It seems like the thing that would most help (funding free/attainable healthcare and mental health/addiction treatment) is the very last thing that any would consider.
- okreallywtf 8y ago
  I've had discussions with coworkers and friends about this issue and similar issues where there is a lot of moral ambiguity but a lot less academic ambiguity - we basically know what works and doesn't work but what does work is not morally acceptable to about half the country. It is super frustrating to a lot of us because there doesn't seem to be a way to reach them, they can change their minds but only when they are personally affected by the issue but it doesn't seem to then spread much to their peers. To paraphrase one conversation that reminded me a lot of the larger national conversation "I play by the rules, why shouldn't everyone else?". It didn't matter that punishment didn't help or in a lot of cases, was costing them more and having worse outcomes, the larger (and to me, more trivial) moral and emotional argument won out.
merinowool 8y ago
Everyone who supports prohibition has blood on their hands. No, your ignorance and stupidity is not an excuse. Pathetic people.

149 points by Alex3917 8y ago

akuji1993 8y ago

When I opened this, I thought they meant 72000 on the whole world. Nope, it's just the US. That's an unbelievably high number to me.

jgtrosh 8y ago
It's staggering! I just compared with traffic accident fatalities in 2017 and it's 40,200 (according to [1]). It hadn't occurred to me that drugs were a bigger killer than traffic accidents. Now maybe there's a big overlap over the two figures? Edit: just realized the drug death count is only for ODs, so the overlap wouldn't be significant. [1]: https://www.nytimes.com/2017/02/15/business/highway-traffic-safety.html https://www.nytimes.com/2017/02/15/business/highway-traffic-...
DanBC 8y ago
Look at the rate of opioid use in the US compared to the rest of the world. The US consumes about 99% of the world supply of hydrocodone. https://www.washingtonpost.com/news/wonk/wp/2017/03/15/americans-use-far-more-opioids-than-anyone-else-in-the-world/?utm_term=.b5705cca9112 https://www.washingtonpost.com/news/wonk/wp/2017/03/15/ameri... These figures are old (2015), but eye-opening. http://www.painpolicy.wisc.edu/who-regional-office-americas-amro http://www.painpolicy.wisc.edu/who-regional-office-americas-... http://www.painpolicy.wisc.edu/sites/default/files/sites/www.painpolicy.wisc.edu/files/amro_oxycodone.pdf http://www.painpolicy.wisc.edu/sites/default/files/sites/www... http://www.painpolicy.wisc.edu/sites/default/files/sites/www.painpolicy.wisc.edu/files/amro_morphine.pdf http://www.painpolicy.wisc.edu/sites/default/files/sites/www... Here's EURO http://www.painpolicy.wisc.edu/sites/default/files/sites/www.painpolicy.wisc.edu/files/euro_oxycodone.pdf http://www.painpolicy.wisc.edu/sites/default/files/sites/www... http://www.painpolicy.wisc.edu/sites/default/files/sites/www.painpolicy.wisc.edu/files/euro_morphine.pdf http://www.painpolicy.wisc.edu/sites/default/files/sites/www... You can use that site to compare regions. http://www.painpolicy.wisc.edu/explore-data http://www.painpolicy.wisc.edu/explore-data
glbrew 8y ago
It really is huge. It is so high experts describe it as a "demographic change," It is literally changing the demographics and population distribution of the US.

bumholio 8y ago

I cannot but wonder if North Americans feel responsible in the least for what their voracious appetite for drugs is doing south of the US border. Mexico has become almost ungovernable, the drug trade being one of the main factors driving the decline.

dasil003 8y ago
The appetite for drugs or the criminalization that creates the black market? Heavy drug users have more immediate concerns than second and third order effects of their lifestyle choices. The politicians and lobbyists responsible for maintaining the status quo on the other hand, should probably pull their heads out of their asses.
- bumholio 8y ago
  I am sure a widescale decriminalization of hard drugs south of the US border will be applauded in Washington. It would solve a large part of the drug crime problems in these countries, while raining down industrial quantities of pharmaceutical grade heroin on the US streets.
  - JamesBarney 8y ago
    I had a ex-friend(went to middle school with him) die recently from a drug overdose, and when I was talking with his parents on the way to the burial site his dad said that he could take him to any town in the U.S. and he could find heroin, get back to the hotel, and get high in under an hour. I don't think supply is limiting the amount of drugs that abusers are doing.
  - dredds 8y ago
    It was tried, was a success, and wasn't applauded. https://news.ycombinator.com/item?id=17608261 https://news.ycombinator.com/item?id=17608261 It's been effective in the countries that have tried it since. Overdose is the failure of dose management. Harm reduction is less profitable than addiction. Wars create jobs and huge profits. Collateral damage is the human cost. Success wasn't the goal.

announcerman 8y ago

The amount of responsibility laundering that's happening is staggering. Is it the fault of the doctors for prescribing strong painkillers or the responsibility of lobbyists for keeping the status quo as it is. Or is it the responsibility of patients to not seek strong opiates for the smallest aches? On whom falls the blame for this?

thedailymail 8y ago
You forgot to mention the drug manufacturers like Purdue, which aggressively promoted their opioids (e.g., Oxycontin) as presenting only a very low risk of addiction and abuse. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/
ryan-allen 8y ago
A few documentaries I've watched suggest that the dosages as recommended by the drug companies are designed to induce withdrawal symptoms before the next dose is due during treatment, I'd wager that's a good way to induce dependence during the course of treatment. The hypocrisy of the law when it comes to this is insane, but given how large the profits are and the power that money commands with lobbying, I'm not really surprised.
- SquareWheel 8y ago
  Honestly, that sounds very conspiratorial and baseless. It assumes doctors are idiots and drug producers are comic book villains. Reality is more nuanced.
  - oldgradstudent 8y ago
    Sadly, assuming by default (until proven otherwise) that doctors are idiots, and drug producers are comic book villans may be the smart thing to do. http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/ > Purdue has known about the problem for decades. Even before OxyContin went on the market, clinical trials showed many patients weren’t getting 12 hours of relief. Since the drug’s debut in 1996, the company has been confronted with additional evidence, including complaints from doctors, reports from its own sales reps and independent research. Or https://study329.org https://study329.org

crazy_monkey 8y ago

Thanks big pharma!

deleted 8y ago

[deleted]

simula67 8y ago

> Analysts pointed to two major reasons for the increase: A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year. So, the increase in deaths is likely because of drugs becoming more deadly. How are drugs becoming more deadly ? It seems like this is how: > Strong synthetic opioids like fentanyl and its analogues have become mixed into black-market supplies of heroin, cocaine, methamphetamine and the class of anti-anxiety medicines known as benzodiazepines. Unlike heroin, which is derived from poppy plants, fentanyl can be manufactured in a laboratory, and it is often easier to transport because it is more concentrated. > In some places, the type of synthetic drugs mixed into heroin changes often, increasing the risk for users So, preventing this blending of drugs could potentially improve the situation > The number of opioid users has been going up “in most places, but not at this exponential rate,” said Brandon Marshall, an associate professor of epidemiology at the Brown University School of Public Health. “The dominant factor is the changing drug supply.” Not sure how this happens is explained in the article, but that could potentially be another attack vector

merinowool 8y ago
If people had easy access to clean drugs, deaths could be avoided. Opiates are fairly safe if dose is correct and are not contaminated. Then people could get psychological help to remove the need to take them.

toomanybeersies 8y ago

As a comparison, the road toll in the USA is 33,000 per year. Firearms kill about the same number (including 20,000 suicides). 3,000 people were killed in the 9/11 attacks. 72,000 overdose deaths is just a staggeringly large number.

emiliobumachar 8y ago
Thanks, you've put the number in perspective. More deaths than cars and guns combined. Staggering indeed.
- greatpatton 8y ago
  And that's the main reason life expectancy in the US is declining: https://www.sciencedaily.com/releases/2018/08/180815190526.htm https://www.sciencedaily.com/releases/2018/08/180815190526.h...
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village-idiot 8y ago
Overdosed actually overtook vehicle deaths before most public health officials realized that something horribly wrong was going on. That we still haven’t done much about it is deeply distressing, tbh. I feel it’s a sign that we’re losing the ability to act towards unified goals, even politically safe ones like “no more drug overdoses please”.
- CydeWeys 8y ago
  Stopping drug overdoses is far from a politically safe goal though, because you need to stop the war on drugs and take a less draconian approach, which goes directly against the hard-line stance of the Republican party.
  - village-idiot 8y ago
    Eh, I think you might be injecting too much partisanship into my original point. Stopping drug overdoses is popular across the board, but some of the tactics to accomplish that are not. We aren’t even at step zero, pretending to give a shit at the national level. You also need to factor in the victims, or rather their demographics. To be brutally honest, past victims of heroin were often minorities who lived in inner cities. Blacks in urban ghettos and gays cut off from all social support in particular, plus homeless people of all stripes. It was easy for people to pretend that those victims were simply immoral fools who got their just desserts. Now the victims are increasingly the children of white, suburban, middle class families. This has brought the crisis much closer to the heart of American political power, and made it much easier for the average voter to know someone who is addicted to or died from opiates. In theory this should reduce the drive for draconian drug war tactics, since the victims are neighbors and not brown boogeymen over in the big bad city. This doesn’t seem to be happening at the political level, which is weird and disconcerting.

PiggySpeed 8y ago

This is absolutely terrible. I worked in an inner-city setting servicing the addictions and psychiatry population as the fentanyl crisis started evolving several years ago. I would see the usual patient every day with no signs of instability, until they suddenly disappeared for a few days and were later found to have overdosed. Perfectly ordinary, pleasant people. We try to prevent these events by sending teams around to check up on them daily. However, resources are limited and we couldn't closely monitor everyone. One of our patients had come across multiple close calls, but no amount of persuasion would entice him to use his drugs in one of those public injection sites, or to invest more heavily in drug therapy. I have some hope for injectable hydromorphone programs being offered in pharmacies. Patients would come into a private room with a dose already measured out by the pharmacist. Pharmacies can already offer an unparalleled degree of monitoring since they see their patients on a daily basis.

merinowool 8y ago
Too many people profit from those deaths to have this happened.

Nursie 8y ago

The war on drugs is a staggering failure. Drugs have infiltrated every level of society, from business leaders and politicians to white and blue collar workers, to the bums on the street. Drugs are causing tens of thousands of deaths a year in the US alone. I dread to think the global total. The casualties of this war are mounting up rapidly. This is before we even count the criminals and enforcers killed in open combat. Whole countries are on the verge of civil war or just plain collapse. Yet in most countries talk of reform is either treated disparagingly or suspiciously, as if all the speaker is interested in is a quick toot, or as if they are a collaborator or traitor. It's sick, it's weird, and it's deeply disastrous. Meanwhile in Portugal, where possession is decriminalised, things seem to get better all the time.

ssijak 8y ago
It is very hypocritical for some politician to tell me what I can and what I can`t put into my body. Recently in UK they enacted a law that criminalize any substance that changes how you feel, but with the following remark "The ban is so wide-ranging that a long list of substances such as alcohol, tobacco, caffeine, food and medical products will have to be given special exemptions." When you thought that you reached the limits of hypocrisy...
- Nursie 8y ago
  Whilst I agree with you - this doesn't even seem like the important piece any more. The ludicrous policies are killing hundreds of thousands a year and making life hell for so many more. It shouldn't even be a question about the morality of taking drugs or the hypocrisy of trying to stop it while carving out extensions any more - it's way more important than that.
- claydavisss 8y ago
  If you expect society to share the burden of funding your healthcare, you should expect to share oversight of your habits.
  - maxerickson 8y ago

throwaway77384 8y ago

Why decriminalise drug use, when you can reap billions in profits from the deaths of thousands instead? I'm not sure that's what people meant when they requested drugs be regulated and taxes used for the greater good...

some_account 8y ago

This is by design. Look at any comedy movie these days, and the young adults are doing drugs. It has become as natural as eating junk food. People view being drugged and dumb to be fine these days because that's the Hollywood propaganda and it's everywhere in western society.

pjc50 8y ago
.. are you sure? This is the same Hollywood that's been editing cigarettes out of movies? Could you cite an example scene?
- yznovyak 8y ago
  ??? Are you for real? Just google "stoner movies". Off top of my head: The Pineapple Express, This is the End, Harold and Kumar go to the White Castle, Jay and Silent Bob strike back.
  - pjc50 8y ago
    Weed (now legal in several states and not related to overdose deaths) is a different prospect to opiates, though.
    - yznovyak 8y ago
      You can argue that weed is legal because of sustained Hollywood propaganda.
  - cogidub 8y ago
    I'm not sure stoner movies are equivocal to increasing broader drug use generally. Studies show that legal marijuana is associated with decreasing opiate prescriptions https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2676997 https://jamanetwork.com/journals/jamainternalmedicine/articl...
Entalpi 8y ago
Blaiming peoples behaviour on entertainment products is a very weak claim. Might as well blaim the gun violence on video games.

justsomedude43 8y ago

Natural selection.

phito 8y ago
Being addicted is not a weakness. Some drugs are stronger that any willpower. When your doctor prescribes it to you like candy, it's really not the person's fault if he becomes addicted to it. Please don't be ignorant and blame the victims.
- justsomedude43 8y ago
  Being addicted is not, but becoming addicted is. Nobody is physically forced into addiction.
  - PiggySpeed 8y ago
    Counterexample: patient has severe pain, is treated in the hospital with opiates, becomes addicted to opiates.
  - Uberphallus 8y ago
    Actually there are genetic factors that predispose you to addictive behaviors and substances. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715956/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715956/
  - Kurtz79 8y ago
    As OP says, many became addicted because of normal painkillers prescriptions from their doctors, not because they wanted to act cool in front of their friends. You don't generaly second-guess your doctor's prescription.
PiggySpeed 8y ago
Wrong attitude. I think you would benefit from meeting more people from different socioeconomic backgrounds.

yters 8y ago

Interestingly, this all is happening through legal routes. What would happen if hard drugs are fully legalized? Another weird thing, there are already loads of deaths through overdoses in the inner city, but only now it is an epidemic? What changed?

Apfel 8y ago
I see your point, but most overdoses are likely due to imperfect dosage information (excluding suicide, obviously). I think there may be some argument for legalisation but with medically-supervised consumption in pharmacies or specialised clinics. Overdoses could (excepting human error) be removed entirely with improved dosage calculations from experienced healthcare staff.
3x 8y ago
Overdoses would decrease. Nearly all recreational drugs should be legalized with regulation to promote safe drug use. These substances should be sold in single individually-packaged doses, with clear and explicit labeling. Taxation can be used to selectively promote the use of safer alternatives to the hardest drugs, for example making marijuana, opium, and mushrooms cheap compared to drugs with a high risk of overdose or long term health implications. The most dangerous drugs like fentanyl can remain prohibited and there will be no market left for them. And, most important of all, the violent black market around drugs would be massively diminished, and there would no longer be situations where addicts are scared to call an ambulance because they will end up in jail. Inconsistent drug purity by itself is a huge factor in opioid overdoses, and it is one of many harmful side effects of criminalization that will effectively disappear under a well-regulated legal market.
- yters 8y ago
  The prior question is: what is causing overdoses? My understanding is the opioids are already regulated, controlled, and dosed appropriately, since most are acquired through medical prescription. Why so many overdoses, then? My hypothesis is the drugs are addictive, and it takes more to get the same high each time, which eventually leads to accidental overdose. Additionally, drug use can lead to feeling trapped and hopeless, and that might cause people to either carelessly or intentionally overdose.

austincheney 8y ago

I have always wondered how pain killers could be so addictive. Stimulants are physically addictive. They modify signals in your physiology to increase signal performance, in some way, and the body reacts to the temporary performance boost. There is a craving for the stimulant the body has becoming reliant upon and a withdrawal in the absence of that chemical. This manner of physical addiction isn't a choice and everybody is roughly equally at risk. Even laxatives are equally physically addictive in this manner even though there is absolutely no modification to behavior from laxative consumption. Pain killers, and other depressants, on the other hand, don't work this way. With a very narrow exception to extreme alcohol consumption depressants are not immediately physically addictive. They require a modification to behavior to be addictive. In this way marijuana, which has no known physically addictive properties, has shown to be addictive to a small segment of users. I have always wondered how depressant addiction occurs. Unlike with stimulants we are not all created equal. Some people are more prone to addiction from depressants than others. Some few people do not find depressants at all addicting and even detest their use. It makes me wonder what is the primary behavioral switch that enables this manner of addiction.

Nursie 8y ago
It's rather simplistic to view opiates as mere depressants. They also create euphoria. I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe, or that you can generalise across multiple, vastly different families of drugs like this...
- austincheney 8y ago
  > It's rather simplistic to view opiates as mere depressants. They also create euphoria. Perhaps for some people that is true. I was given a strong does of opiates for pain at a hospital before and I did not find the experience either pleasant or euphoric. That level of numbness and loss of motor control was actually a dreadful and even fearful experience. It really made me question which was worse between that experience and the pain it relieved. > I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe Are there exceptions?

nkkollaw 8y ago

Pharmaceutical companies keep lobbying for being able to give people opioids lightly, and keep giving doctors bonuses, to get people hooked until it's too late to go back. It's really true that the world works backwards. That's hundred of times the deaths from terrorism, yet the US government is completely ignoring this trend. If heroin is criminalized, so should be these practices, yet everyone is making money off of this: corporations, doctors, shareholders, politicians.

sergefaguet 8y ago

and while this opioid shit is legal, psilocybin and LSD are not. why should i have any respect for the legal system again? as opposed to seeing it as a dumb bully with no moral authority?

qudat 8y ago

How many of these overdoses were because of suicide?

dalbasal 8y ago

Looks like a sharp rise in heroine, cocaine & speed deaths too, even if shallower than opioids. Curious what a longer term chart would look like. This only charts 3 years. Is it normal, having such big annual changes?

perl4ever 8y ago

It seems like the term "overdoses" is obscuring the problem which is more "toxic (lethal) stuff is increasingly being mixed into illicit drugs of all kinds".

perl4ever 8y ago
This point happens to be prominent in my mind, because I happened to see some material the other day intended for drug education in schools that talked about the dangers of marijuana, especially the "synthetic kind". Even though I am not particularly pro-pot, and I do see the real problem here, it made me very uncomfortable. The less misleading thing to say, in my opinion, would be simply "street drugs can have poison or unknown drugs in them, and can kill you". Framing the problem is not just a matter of arbitrary mental games. Empirically, there is a real phenomenon, that people are dying more than they used to, and blaming doctors is the consequence of not reasoning properly about it. Unregulated drugs have always had the potential to have bad things in them, but if that is an increasing problem, we need to find out the root cause. Assuming doctors or drug companies have become greedier, assuming victims have become more susceptible to addiction, strike me as refusing to acknowledge what an explanation would even look like.
pitaj 8y ago
There's a simple solution: legalize all drugs. All of them. Let people get what they want. Then, if the government must do something, pump all that money they were spending on the drug war into treatment centers.
- perl4ever 8y ago
  I can't see how eliminating regulation of drugs is going to solve the problem of people getting substances that are harmful or ineffective. There is no simple solution, only the obvious complicated one of regulating correctly.

naccato 8y ago

The sad truth is, the U.S. is a country that emphasizes punishment over rehabilitation, and we've brought this upon ourselves by isolating people and banning access to substances that they've become dependent on. The solution here is not complex: give addicts safe access to the substances they're addicted to and resources for improving their situation. It's disheartening, to say the least, that one of the main strategies for dealing with this is apparently "reducing medical prescriptions of opioids". People are in pain -- they need to be helped. I highly recommend the book Chasing the Scream, for anyone who's looking for a primer on the War on Drugs. It traces the hysteria around drug use back to the 1930s, when race panic was used to push forward prohibition in the face of mounting evidence against that strategy.

shady-lady 8y ago
On "Chasing the Scream", I would just include the disclaimer that Seth Mnookin(a professor of science writing at M.I.T) in his NYT review stated: > Unfortunately, his misunderstanding of some of the basic principles of scientific research — that anecdotes are not data; that a conclusion is not a fact — transforms what had been an affecting jeremiad into a partisan polemic. https://www.nytimes.com/2015/02/15/books/review/chasing-the-scream-by-johann-hari.html https://www.nytimes.com/2015/02/15/books/review/chasing-the-...
taurath 8y ago
The traditional rural tough on crime voters are now dealing with the dissonance when its their communities and families that are being ripped apart. It seems like the thing that would most help (funding free/attainable healthcare and mental health/addiction treatment) is the very last thing that any would consider.
okreallywtf 8y ago
I've had discussions with coworkers and friends about this issue and similar issues where there is a lot of moral ambiguity but a lot less academic ambiguity - we basically know what works and doesn't work but what does work is not morally acceptable to about half the country. It is super frustrating to a lot of us because there doesn't seem to be a way to reach them, they can change their minds but only when they are personally affected by the issue but it doesn't seem to then spread much to their peers. To paraphrase one conversation that reminded me a lot of the larger national conversation "I play by the rules, why shouldn't everyone else?". It didn't matter that punishment didn't help or in a lot of cases, was costing them more and having worse outcomes, the larger (and to me, more trivial) moral and emotional argument won out.

merinowool 8y ago

Everyone who supports prohibition has blood on their hands. No, your ignorance and stupidity is not an excuse. Pathetic people.